The predictive value of exhaled nitric oxide measurements in assessing changes in asthma control
The predictive value of exhaled nitric oxide measurements in assessing changes in asthma control
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DOI：
10.1164/ajrccm.164.5.2012125
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发表时间：
2001-09-01
影响因子：
24.7
通讯作者：
Taylor, DR
中科院分区：
文献类型：
--
作者：
Jones, SL;Kittelson, J;Taylor, DR
呼出的一氧化氮（eNO）水平在未经治疗或不稳定的哮喘中增加，并且可以很容易地进行测量。我们的目的是评估eNO在诊断和预测激素停药后哮喘失控（COPD）中的作用。对痰嗜酸性粒细胞和气道高反应性（AHR）高渗盐水（4.5%）进行了比较。78例轻度/中度哮喘患者停用吸入性类固醇治疗，直至发生哮喘或最多6周。60例（77.9%）发生了腹泻。eNO的变化与症状（p < 0.0001）、FEV 1（p < 0.002）、痰嗜酸性粒细胞（p <0.0002）、生理盐水PD 15（p < 0.0002）呈高度显著性相关，且有效率组与无效率组间差异有显著性。单次测量和eNO的变化（10 ppb，15 ppb，或超过基线增加> 60%）对预测和诊断COPD具有80%至90%的阳性预测值。这些值与使用痰嗜酸性粒细胞和生理盐水PD 15测量获得的值相似。我们的结论是，eNO测量是有用的诱导痰分析和AHR在评估气道炎症，其优点是，他们很容易执行。
Exhaled nitric oxide (eNO) levels are increased in untreated or unstable asthma and measurements can be made easily. Our aim was to assess the usefulness of eNO for diagnosing and predicting loss of control (LOC) in asthma following steroid withdrawal. Comparisons were made against sputum eosinophils and airway hyperresponsiveness (AHR) to hypertonic saline (4.5%). Seventy-eight patients with mild/moderate asthma had their inhaled steroid therapy withdrawn until LOC occurred or for a maximum of 6 wk. Sixty (77.9%) developed LOC. There were highly significant correlations between the changes in eNO and symptoms (p < 0.0001), FEV1 (p < 0.002), sputum eosinophils (p < 0.0002), and saline PD15 (p < 0.0002), and there were significant differences between LOC and no LOC groups. Both single measurements and changes of eNO (10 ppb, 15 ppb, or an increase of > 60% over baseline) had positive predictive values that ranged from 80 to 90% for predicting and diagnosing LOC. These values were similar to those obtained using sputum eosinophils and saline PD15 measurements. We conclude that eNO measurements are as useful as induced sputum analysis and AHR in assessing airway inflammation, with the advantage that they are easy to perform.